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C 组链球菌所致中毒性休克综合征

Toxic Shock Syndrome From Group C Streptococcus.

作者信息

McCullough Jocelyn, Wasim Shehnaz, Zachary Kuschner, Nizza Philip

机构信息

Medical Education, Zucker School of Medicine, Port Jefferson, USA.

Critical Care Medicine, Zucker School Of Medicine, Port Jefferson, USA.

出版信息

Cureus. 2022 Aug 19;14(8):e28190. doi: 10.7759/cureus.28190. eCollection 2022 Aug.

Abstract

We present a patient who was admitted with lower extremity cellulitis and was found to have Group C bacteremia causing toxic shock syndrome. Our patient was started on appropriate antibiotics, which included piperacillin/tazobactam, vancomycin, and clindamycin for presumed cellulitis, and was later transitioned to meropenem on day two when she was found to have gram-positive group C bacteremia and was treated for 14 days. Additionally, she was initiated on a three-day regimen of intravenous immunoglobulin (IVIG) as an adjunctive treatment for worsening clinical status from toxic shock syndrome. Our patient survived up to 46 days post admission but ultimately succumbed to her illness. It is worthwhile to state that the addition of IVIG could have prolonged her survival. We emphasize the importance of timely diagnosis and treatment with antibiotics and IVIG to help prevent mortality from this condition.

摘要

我们报告一名因下肢蜂窝织炎入院的患者,发现其患有丙型链球菌血症并导致中毒性休克综合征。我们的患者开始使用适当的抗生素,包括哌拉西林/他唑巴坦、万古霉素和克林霉素,用于治疗疑似蜂窝织炎,后来在第二天发现她患有革兰氏阳性丙型链球菌血症时,改用美罗培南,并接受了14天的治疗。此外,她开始接受为期三天的静脉注射免疫球蛋白(IVIG)治疗,作为中毒性休克综合征导致临床状况恶化的辅助治疗。我们的患者在入院后存活了46天,但最终还是因病去世。值得一提的是,添加IVIG可能会延长她的生存期。我们强调及时使用抗生素和IVIG进行诊断和治疗对于预防这种疾病导致死亡的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3a3/9482823/ebe5bd340217/cureus-0014-00000028190-i01.jpg

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